116 Calvary Church WayDavie County, NC r Tax Parcel Report b 6'!, Y Wednesday, October 5, 2016
WARNIN is '1711, 1, INU"Y A NUKVEY
Parcel Information
Parcel Number: J60000002501 Township: Mocksville
NCPIN Number: 5757071274 Municipality:
Account Number: 82517514 Census Tract: 37059-807
Listed Owner 1: SHERRILL DOROTHY HOLMAN Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: 116 CALVERY CHURCH WAY Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
NC Zoning Overlay:
27028-0723 Voluntary Ag. District:
0.512 AC OFF DALTON RD Fire Response District:
0.52
Elementary School Zone:
8/2001
Middle School Zone:
003810520
Soil Types:
Flood Zone:
Watershed Overlay:
50370.00
Outbuilding 8r Extra
Freatures Value:
9020.00
Total Market Value:
63890.00
No
FORK
CORNATZER
WILLIAM ELLIS
PaD,CeI32
DAVIE COUNTY
4500.00
63890.00
�pU N,t'ti
Davie County,
NC
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County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
AUTHORIZATION N, O: 0 5 3 6, DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
PermitJee^e' ~' �{ / / j P.O. Box 848
Name: 1. i"�} &_1 A1_LZVZ4 Z') Mocksville, NC 27028 Subdivision Name:
,� .+
Directions to property: '�::y/�; • r�`f% Phone #: 704-634-8760 Section: Lot:
f AUTHORIZATION FOR
ra
LID,- WASTEWATER Tax Office PIN:# r f rl_ �, r! -
SYSTEM CONSTRUCTION
1 (`�
• Road Name: /-�'1FI i_ . of Zip: AQ a+'?
**NOTE** This Authorization for Waste ter System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
Y w•,. '.c,.. �. iY,f �; �,;;,..�,; « DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS
Permit'ls
Directions to property:
AJ
i (r) N110 01-�Iklr,4 t (/\Ja.L t
ai�e'YryQ
PROPERTY INFORMATION
Subdivision Name:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# �� F�" �_ £� r t
Road Name: tl .:1._- s ;�; l Zip. T
**NOTE** This Improvement Permit bOIfS NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance wiih Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE ZV� # BEDROOMS - # BATHS / # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
11,4,11
NEW SITE REPAIR SITE t/�
LOT SIZE TYPE WATER SUPPLY ! _LDESIGN WASTEWATER FLOW (GPD)
SYSTEM SPECIFICATIONS: TANK SIZES u[., GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH -,Z � 'LINEARTT.
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
A, /— X, xoy,/
V J
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. O�!a b OPERATION PERMIT BY: _tea DATE:zbsk2
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS ' 1�
.v ;1 Davie County Health Department D,v
Environmental Health Section D
d S P. O. Box 665
C Mocksville, NC 27028 1JAY 3 1 1996
J I
/l,.7 ,// -VL
1. Application/Permit Requested By `(a a So}�
Mailing Address L l ,mfr[ �1 C 7 o X `d Home Phone
q-31 mat' ' '� Business Phone
2. Name on Permit if Different than Above
3. Application for: General Evaluation UMeptic Tank Installation Permit
4. System to Serve: ❑ House
❑ Business ❑ Industry
5. If house, mobile home: Subdivision
No. of People of
No. of Bedrooms 3
No. of Bathrooms
Dwelling Dimensions
2 Mobile Home ❑ Place of Public Assembly
❑ Other ❑ Unknown
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: Public ❑ Private
8. Property Dimensions 4TJ3Q Sewage Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
Section Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
E&4ashing Machine
❑ Dishwasher
❑ Garbage Disposal
❑ Yes �o
❑ Community
`NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
4.
� V4J.e s
RMATION REQUIREb:
`max Office PIN: 5757- o7- 03(03
PROPERTY AbbRESS, as follows:
Road Name: "Dediu,
City: me)cy-ku"Ite-
SU13MIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
91 -
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the Davie County Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's uit bility for a ground absorp 'o sewage treatment
and disposal system.
DATE ZY SIGNATURE
DCHD (1/93)
r = DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation %
NAME !` DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY �%% LOCATION OF SITEra
Water Supply: On -Site Well _ Community Public.—.,-----
Evaluation
ublic,.,-.---Evaluation By: Auger Boring ✓ Pit Cut
FACTORS
1 2
3 4
Landscape position
Slope Z
�-
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH
Texture group-
C -
Consistence
6
Structure
Mineralogy
-
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralog
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: J
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-901
EVALUATED BY: / 471 ��
OTHER(S) PRESENT:
LEGEND
Landscape Position
R -Ridge S. -Shoulder L -Linear slope FS -Foot slope N -Nose slope
CC -Concave slope CV -Convex slope T -Terrace FP -Flood plain H -Head slope
Texture
S -Sand LS -Loamy sand SL -Sandy loam L -Loam SI -Silt
SICL-Silty :lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- V! --.-y friable FR -Friable FI -Firm VFI-Very firm EFI-Extremely firm
Wet
NS -Non sticky SS -Slightly sticky S -Sticky VS -Ver -j Sticky
NP -Non plastic SP -Slightly plastic P -Plastic VP -Very plastic
Structure
3C -Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
Mineralogy
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water or inches from land surface to soil colors
with chroma 2 or less
Classification - S(suitable), PS (provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2
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Davie County Health Department
r
and Home Heafth .Agency
Environmenta[Heafth Section
P.O. BOX 848 / 210 HOsPtrAL STREET
COURIER #09-4-06
MOCKsvtuE, N.C. 27028
PHONE: (704) 694-8760
June 25, 1998
Dorothy L. Hollman
857 Salisbury St:
Mocksville, NC 27028
Re: Site Evaluation
Dalton Road
Tax PIN: #5757-07-0383
Dear Ms. Hollman:
As requested, a representative from this office visited the aforementioned
site on June 21, 1998. Based upon the information provided on the application
for site evaluation and after the evaluation was completed, the site was found
to be provisionally suitable for the installation of an on—site sewage disposal
system.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure(s)